The Fall Prevention Center of Excellence (FPCE) is a source of
fall prevention
Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the elderly (idiopathic) and people with neurological (Parkinson's, Multiple sclerosis, stroke survivors, Guilla ...
information for older adults, families,
caregiver
A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commo ...
s, professionals,
service provider
A service provider (SP) is an organization that provides services, such as consulting, legal, real estate, communications, storage, and processing services, to other organizations. Although a service provider can be a sub-unit of the organization t ...
s, researchers, and
policymakers
Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...
. FPCE's aim is to provide leadership, create new knowledge, improve practices, and develop fall prevention programs.
The center's goals are to advance fall prevention as a
public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
priority and educate and train service providers and professionals in fall prevention. It also aims to development and implement fall prevention programs that address the needs of older adults.
History
To address the problem of falls, the Archstone Foundation held the first statewide Fall Prevention Summit in 2003 of over 150
stakeholders representing government, professional, and community organizations. A major outcome was the creation of FPCE with support from the Archstone Foundation to implement FP awareness and building a statewide FP infrastructure.
A background
White Paper
A white paper is a report or guide that informs readers concisely about a complex issue and presents the issuing body's philosophy on the matter. It is meant to help readers understand an issue, solve a problem, or make a decision. A white paper ...
was developed prior to the conference. Afterwards, a Blueprint for Fall Prevention was created.
In March 2004, a one-day event on fall prevention was held at the American Society on Aging/
National Council on Aging
The National Council on Aging (NCOA) was founded in 1950 as the first charitable organization in the U.S. that would advocate for older Americans with service providers and policymakers. Headquartered in Washington, DC
)
, image_skyline ...
Joint Conference. In January 2005, the Fall Prevention Center of Excellence was established.
Partners and affiliates
Partners
FPCE is partnered with the
University of Southern California
The University of Southern California (USC, SC, or Southern Cal) is a Private university, private research university in Los Angeles, California, United States. Founded in 1880 by Robert M. Widney, it is the oldest private research university in C ...
's (USC)
Andrus Gerontology Center (Andrus), and the Center for Successful Aging (CSA) at
California State University, Fullerton
California State University, Fullerton (CSUF or Cal State Fullerton) is a public university in Fullerton, California. With a total enrollment of more than 41,000, it has the largest student body of the 23-campus California State University (CSU) ...
.
Andrus serves as the program office, is responsible for administrative responsibilities and serves as the communication/dissemination site. They share their expertise in the environment, particularly home and community safety in relation to fall prevention, and they operate an executive certificate program in home modification. Their director of communications is Maria Henke and the co-director is Jon Pynoos.
CSA offers instructor training for a group physical activity program called FallProof. The instructors conduct group physical activity classes in the community. They specialize in balance and mobility as a strategy for fall risk reduction. The co-director is Debra Rose.
Affiliates
FPCE is
affiliated with:
* The VA Greater Los Angeles Healthcare System Geriatric Research, Education and Clinical Center (GRECC)
*
University of California Los Angeles
The University of California, Los Angeles (UCLA) is a public land-grant research university in Los Angeles, California. UCLA's academic roots were established in 1881 as a teachers college then known as the southern branch of the California ...
(UCLA), Geffen School of Medicine
* The
California Department of Public Health
The California Department of Public Health (CDPH) is the state department responsible for public health in California. It is a subdivision of the California Health and Human Services Agency. It enforces some of the laws in the California Healt ...
, Safe and Active Communities Branch (SACB)
* University of Southern California, School of Pharmacy (USC Pharmacy)
GRECC conducts research in fall prevention. They share their expertise in
medical management
Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital network ...
of risk factors for falls and are skilled in evaluating fall prevention programs.
SACB works with
Epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evidenc ...
and Prevention for Injury Control (EPIC) to track and identify causes and frequencies of fall-related injuries across the state. They promote fall prevention at the state level and share their expertise in improving programs and services available to reduce fall risk.
USC Pharmacy offers dual degrees in Pharmacy and
Gerontology
Gerontology ( ) is the study of the social, cultural, psychological, cognitive, and biological aspects of aging. The word was coined by Ilya Ilyich Mechnikov in 1903, from the Greek , ''geron'', "old man" and , ''-logia'', "study of". The fie ...
for students interested in pursuing geriatric pharmacy practice. They specialize in the pharmaceutical management of risk factors for falls.
FPCE:
* creates and distributes multilingual materials on its website,
* provides online and in-person education,
* provides technical assistance to 11 regional fall prevention coalitions in California,
* coordinates a Californian FP network,
* is developing a fall prevention program (InSTEP),
* has convened two statewide summits on FP.
FPCE is supported by the California Wellness Foundation, the
Kaiser Foundation
The Kaiser Foundation is a mental health organization based in Canada. Its stated mission is to assist individuals and communities in preventing and reducing the harm associated with problem substance use and addictive behaviours. Although founded ...
, The Eisner Foundation, the SCAN Foundation, and the
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
(CDC). This support has augmented the resources provided initially by the Archstone Foundation and allowed FPCE to more widely reach older adults and underserved minorities by building the capacity of professionals and providers to address falls.
At the national level, FPCE's partners include the National Council on Aging (NCOA) and the Falls Free Coalition, the
National Safety Council
The National Safety Council (NSC) is a 501(c)(3) nonprofit, public service organization promoting health and safety in the United States. Headquartered in Itasca, Illinois, NSC is a member organization, founded in 1913 and granted a congressi ...
, Rebuilding Together, and the CDC. In California, FPCE works with organizations that represent older persons (e.g., AARP), ¬-government (e.g. Departments of Aging, Public Health, and Housing), health and social service providers, and caregiver organizations. Locally, FPCE partners with Area Agencies on Aging, the County Department of Public Health and the City and County Fire Departments. FPCE has an Advisory Board.
Importance of fall prevention
Ranking in the top ten causes of death, disability, and healthcare expenditures (Rubenstein, 2006; Ganz et al., 2007), the rate of falls and their associated costs are staggering (Stevens et al., 2006). In Los Angeles County, home to 1.4 million people aged 60 or older, EPICenter data show that approximately one third fall each year. In 2010, there were more than 20,000 hospitalizations for falls among 65+ year olds with an average of $61,800 in medical cost per visit. In California, over 565,000 older people fell more than once in 2007 (Wallace et al., 2010) and the costs of falls in California could reach $6.6 billion in 2020 (Trent, written communication, 2010). The fear of falling can lead to depression, isolation, and loss of independence for older adults.
To address the problem of falls, the Archstone Foundation held the first statewide Fall Prevention Summit in 2003 of over 150 stakeholders representing government, professional, and community organizations. An outcome was the creation of FPCE with support from the Archstone Foundation.
Projects
Fall Prevention Coalition – Los Angeles (FPC-LA)
Funded by The Kaiser Foundation, the vision of FPC-LA is promoting safe fall-free aging. Its mission is to reduce fall risk for older adults through education, planning, and community action across Los Angeles County. Coalition members, including representatives from public, private, and non-profit organizations, have identified “fall hotspots”- zip codes where older people fall at high rates - to help target programs, conducted a Walkability Workshop to highlight hazards to pedestrians such as uneven sidewalks and unsafe street crossings, created a presentation for older adults that is being used by the Department of Public Health Speakers Bureau, and developed The Falling Monologues, a series of performances by an older adult scriptwriter and actors to raise awareness about falls.
FP Connect
This project is funded by the Archstone Foundation. Emergency Medical Services (EMS) personnel are often the first to arrive at the scene of a fall. FP Connect aims to educate Los Angeles County EMS personnel to address fall risks and reduce repeat falls. It enhances the ability of Fire/EMS to respond to falls effectively by providing LACoFD with an information and assessment tool that enables Fire/EMS personnel to conduct a home assessment and connect older adults who have fallen with community services.
Pills & spills
Funded by the SCAN Foundation, the purpose of Pills & Spills is to help direct care workers in nursing homes and older adults’ homes reduce falls through medication and environmental interventions. The Fall Prevention Center of Excellence and the USC School of Pharmacy jointly created six 1-hour in-service sessions with corresponding case studies and video segments of teaching material. Topics include:
* Stop falls: addressing fall risk factors,
* Aging, health, and falls,
* Medical conditions that contribute to falls,
* Recognizing the link between medications and falls,
* Personalizing fall prevention: the environment,
* The 4Ps: Pain, Positioning, Potty, Possessions.
Home Safety Adaptations for the Elderly (Home SAFE)
Funded by the Eisner Foundation, the mission of Home SAFE is to make home safety a component of successful aging and preventive health in LA County by increasing activities and awareness among consumers, professionals, organizations and the wider community. The project's home safety focus areas include:
* fall prevention (elimination of hazards such as throw rugs, clutter),
* home modification (environmental adaptations such as grab bars, better lighting),
* fire protection measures (smoke alarms and escape plans),
* healthy home strategies (carbon monoxide detectors, clean furnace).
An outcome is the development of the Home Safety in Your Community: A Toolkit for Change, with home safety information in English, Chinese, Korean, and Spanish.
Increasing Stability through Evaluation and Practice (InSTEP)
The project is funded by the Archstone Foundation to develop a program aimed at reducing fall risk for older persons at moderate to high risk of falls, FPCE staff analyzed the effectiveness of three basic InSTEP models, which differ by intensity of professional involvement (high, medium and low). Validated instruments were used to measure fall risk behaviors, concerns about falling, fall history, and current physical activities. Multiple physical performance tests were also conducted pre- and post-intervention.
California Senior Fall Prevention Projects: Fall Prevention Coalition Development
The project is funded by the Archstone Foundation. From 2006–2009, ten agencies were supported to create/strengthen fall prevention coalitions in two major areas in California. FPCE provided technical assistance and evaluated their progress. Coalitions conducted assessments to identify their community's greatest needs, created three-year strategic plans to address those needs, and employed strategies to build local capacity to reduce fall risk. During the grant period, the coalitions established four assessment and referral systems and eight resource directories for consumers and professionals covering 14 counties. Over 3,800 older adults were assessed for fall risk and more than 2,500 were referred to local services. Coalitions also trained over 2,800 service providers and educated more than 25,000 caregivers and older adults.
California Senior Fall Prevention Projects: Fall Prevention Program Expansion
Funded by the Archstone Foundation. From 2006–2009, six agencies that were providing direct services to older adults to reduce their risk of falling were supported to integrate additional fall prevention components to their programs, such as balance and mobility training, medical management, and environmental assessment and modification. FPCE provided technical assistance and evaluated their progress. Over the grant period, the Program Expansion Grantees provided fall prevention services for 450 older adults and educated 7,100 seniors and caregivers on fall risks and fall prevention.
References
{{reflist
# Ganz, David A., Bao, Yeran, Shekelle, Paul G., & Rubenstein, Laurence Z. (2007). Will My Patient Fall? JAMA, 297(1), 77–86. doi: 10.1001/jama.297.1.77
# Rubenstein, L.Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(suppl 2), ii37-ii41.
# Wallace, S.P., Pourat, N., Durazo, E., & Leos, R. (2010). Older Californians at risk for avoidable falls.
Elderly care